title: Angiotensin receptor blockers: are they related to lung cancer?
abstract: BACKGROUND
  Angiotensin receptor blockers (ARBs) are commonly used antihypertensive medication with several other additional proven benefits. Recent controversy on association of lung cancer and other solid malignancy with the use of ARBs is concerning, although the follow-up studies have shown no such association.
  
  
  METHODS
  We used data from the Department of Veterans Affairs electronic medical record system and registries to conduct a retrospective cohort study that compared first-time ARB users with nonusers in 1:15 ratio, after balancing for many baseline differences using inverse probability of treatment weights. We conducted time-to-event survival analyses on the weighted cohort.
  
  
  RESULTS
  Of the 1 229 902 patients in the analytic cohort, 346 (0.44%) of the 78 075 treated individuals had a newly incident lung cancer and 6577 (0.57%) of 1 151 826 nontreated individuals were diagnosed with lung cancer. On double robust regression, the weighted hazard ratio was 0.74 (0.67-0.83, P < 0.0001), suggesting a lung cancer reduction effect with ARB use. There was no difference in rates by ARB subtype.
  
  
  CONCLUSIONS
  In this large nationwide cohort of United States Veterans, we found no evidence to support any concern of increased risk of lung cancer among new users of ARBs compared with nonusers. Our findings were consistent with a protective effect of ARBs.
authors.affiliation: Research Department, Veterans Affairs Medical Center, University of South Carolina, Columbia, South Carolina, USA. gowtham.rao@va.gov
authors.forename: Gowtham Adamane
authors.initials: GA
authors.lastname: Rao
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Mann
authors.forename: Azza
authors.initials: A
authors.lastname: Shoaibi
authors.forename: Sachin G
authors.initials: SG
authors.lastname: Pai
authors.forename: Matteo
authors.initials: M
authors.lastname: Bottai
authors.forename: Shawn Scott
authors.initials: SS
authors.lastname: Sutton
authors.forename: Kathlyn Sue
authors.initials: KS
authors.lastname: Haddock
authors.forename: Charles Lee
authors.initials: CL
authors.lastname: Bennett
authors.forename: James R
authors.initials: JR
authors.lastname: Hebert
mesh_terms: D000328:Adult; D000368:Aged; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000009:adverse effects*; D015331:Cohort Studies; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy*; D008175:Lung Neoplasms / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012189:Retrospective Studies; D013997:Time Factors; D014481:United States; D014493:United States Department of Veterans Affairs
chemical_list: D057911:Angiotensin Receptor Antagonists; D000959:Antihypertensive Agents